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Sexual Reorientation Therapy Reconsidered

Warren Throckmorton, PhD
June 27, 2004

Recently, on the website of the Covenant Network of Presbyterians, C. Richard Carlson posted an impressive list of statements from professional mental health associations criticizing sexual reorientation counseling.* This list was offered to counter the study reported by Dr. Robert Spitzer of Columbia University that demonstrated varying degrees of sexual orientation change on the part of 200 study participants. Like so many of his colleagues, Mr. Carlson argues from conventional wisdom and summarily dismisses the lives of former homosexuals without considering their experience.

To be sure, nearly all mental health associations have issued advisories concerning sexual orientation change in counseling. The one that has not, the American Mental Health Counseling Association, has taken no position on the subject. However, these organizations have not banned the practice of sexual reorientation. Consider the words of the Executive Director of the American Psychological Association, Raymond Fowler:

The APA's position on reparative therapy is that those who wish to explore developing heterosexual feelings or behavior have a right to do so as part of every client's right to self-determination. If an individual is comfortable with homosexuality, it is not the role of the therapist to convince the client otherwise. If one's feelings are ego-dystonic and there is a desire to talk about changing, that is an acceptable choice and a psychologist may participate if he or she desires. – Ray Fowler, CEO, APA

This common sense statement makes clear that choosing an objective of reorientation counseling is the decision of the client. Despite the fact that the mental health associations have politicized the issue of change, the APA chief makes it clear that participation does not violate ethical guidelines and may be an acceptable course.

Concerning the politicization of this issue, I can offer the opinion of one who was quoted by Mr. Carlson: Dr. Robert Spitzer. I interviewed Dr. Spitzer for a documentary I produced and recently released called I Do Exist. On the film, Dr. Spitzer is asked if the American Psychiatric Association should revise the position statements revealing skepticism about sexual orientation change. He responded as follows:

I think they should; they will not be. It’s not going to happen in the near future, there’s no way it’s going to happen. I think the only issue is whether it goes beyond the position statement whether they go on to say its an ethical violation to do this kind of therapy but those position statements are not going to change. There’s, there’s a gay activist group that is strong and very vocal and recognized officially by the American Psychiatric Association. There’s nobody to give the other viewpoint. There may be a few people who believe it but they don’t talk. – Dr. Robert Spitzer, 3/04
So despite Dr. Spitzer’s legitimate concerns that people not be forced into reorientation counseling, he clearly favors a revision in the official skepticism of mental health groups toward ex-gays. Dr. Spitzer has frequently commented that no one has any way to determine how many people can or will change, but he has stood by the view that sexual orientation is much more flexible than he thought before he conducted his study. So why would professional associations and writers such as Mr. Carlson overlook the lives of ex-gays and claim reorientation to be ineffective? Dr. Spitzer related a hypothesis concerning that issue on the I Do Exist documentary.

Now I do have to say that one of the concerns of people who have criticized the – the study has been criticized severely by many people particularly gay activists who apparently many feel quite threatened by it. I think they have the feeling that in order for them to get their civil rights its helpful to them if they can present the view that once you’re a homosexual it can never change. Which may actually, they may be right, politically it does help them but it may not be scientifically correct. – Dr. Robert Spitzer; 3/04

Why do critics keep beating the drum to eliminate reorientation counseling? According to Dr. Spitzer, it may have more to do with political objectives than clinical or professional ones.

The truth is Dr. Spitzer found that his participants benefited from their reorientation experiences. Many were quite depressed prior to entering efforts to change sexuality and much improved afterwards. Again from the documentary, I Do Exist, Dr. Spitzer notes: “The majority of the subjects reported moderate to severe depression before they were into therapy and there was marked change. Very few were depressed when we saw them.” In terms of numbers, 42% of men and 47% of women were clinically depressed. After counseling for change, only 1% of the men and 4% of the women continued to experience depression.

In my own research to be reported at the Presbyterian USA General Assembly in June and this summer’s American Psychological Association convention, I found similar improvements in mood and anxiety disturbances for reorientation clients. I found that individuals seeking sexual orientation change described improvement in such problems as depression, anxiety and trauma recovery if their counselors collaborated with them for change. If their counselors applied gay affirming counseling techniques, the clients were significantly less likely to report benefits to their mental health. Therapists who pressured reorientation clients to adopt a gay identity were 5 times more likely than other therapists to be rated as unhelpful. Those who rely on conventional wisdom rather the lives of former homosexuals will miss seeing the whole picture.

Concerning the claims that harm may result from reorientation efforts, the evidence is scanty and mixed. Clearly, some people have experienced distress due to their involvement with counselors who employ methods that are outdated or discredited. There is only one research study that documents harm stemming from reorientation efforts. Even in that study, nearly 10 % of participants did make sexual orientation changes. I am in favor of on-going research to learn the appropriate interventions that are likely to be beneficial for those seeking sexual reorientation. In this way, we can weed out the practices that have harmed people. However, only the most black and white of thinkers would advocate the elimination of interventions that have benefited many people because a few people report harm. Rather than denigrating those whose lives have changed, we should listen and better understand how some of God’s children come to integrate their sexual identity within their faith and beliefs.

Warren Throckmorton, PhD is Director of College Counseling and an Associate Professor of Psychology at Grove City College. Professor, counselor and columnist, Dr. Throckmorton is the producer of the documentary I Do Exist sexual orientation change. His columns have been published in over 40 newspapers and numerous websites. Contact him at or via his websites: or

* C. Richard Carlson's article


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